Некоторые факторы риска воспаления переднего отрезка глаза после хирургии катаракты у пациентов с глаукомой (серия клинических случаев)

Abstract

Purpose. The study purpose was to identify risk factors that increase anterior segment inflammation after cataract surgery in patients with glaucoma. Material and method. We present 3 clinical cases in which anterior segment inflammation was observed after phacoemulsification in patients with combined cataract and glaucoma (with failure of the ligamentous apparatus of the lens, a history of anti-glaucoma surgery and the presence of a complete complicated cataract against the background of a narrow pupil). Results. In the first clinical case, descemetite was biomicroscopically observed on the next postoperative day; the intraocular fluid’s opalescence of the anterior eye chamber. This condition was the result of excessive manipulation during surgery (use of iris retractors and intracapsular ring). The vision on the first day was 0.4 does not correct (n/c), after 7 days it was 0.6 n/c. In the second clinical case, excessive contact with the iris (rupture of synechiae and action of instruments dilating the pupil) resulted in postoperative descemetis, dispersion of iris pigment in the anterior chamber moisture, residual viscoelastic on the endothelium. Vision on the first day after surgery was 0.2 n/c, on the 7th – 0.4 n/c. In the third clinical case, the descemetal folds were a consequence of increased ultrasound activity in a mature cataract as well as of manipulations that dilated the pupil. The day after surgery, visual acuity was 0.5 n/c. Conclusion. These clinical cases demonstrate risk factors of increased anterior segment inflammatory response after phacoemulsification for patients with combined cataract and glaucoma. They are: lens subluxation, previous trabeculectomy, complete complicated cataract and narrow rigid pupil. Key words: cataract, glaucoma, phacoemulsification, intraocular lens, cataract extraction, inflammation